Discordant localization of 2-[18F]-fluoro-2-deoxy-D-glucose in 6-[18F]-fluorodopamine- and [123I]-metaiodobenzylguanidine-negative metastatic pheochromocytoma sites
Discordant localization of 2-[18F]-fluoro-2-deoxy-D-glucose in 6-[18F]-fluorodopamine- and [123I]-metaiodobenzylguanidine-negative metastatic pheochromocytoma sites
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DOI：
10.1097/01.mnm.0000189780.54658.e8
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发表时间：
2006-01-01
影响因子：
1.5
通讯作者：
Pacak, K
中科院分区：
文献类型：
--
作者：
Mamede, M;Carrasquillo, JA;Pacak, K
背景虽然大多数嗜铬细胞瘤（PHEO）是良性的，但也有一部分是恶性的。计算机断层扫描（CT）和磁共振成像（MRI）以高灵敏度定位PHEO，但由于特异性有限，[I-131]-或[I-123]-间碘苄胍（[I-131]-或[I-123]-MIBG）通常用作补充剂。6-氟多巴（[F-18]-DA）已被开发为靶向去甲肾上腺素能通路的放射性药物，并且已显示出比MIBG更好的PHEO位点检测率;然而，在本发明中，[F-18]-DA在某些转移性PHEO患者中缺乏蓄积。方法5例有广泛转移性PHEO患者，（1名男性和4名女性;年龄范围，25 - 64岁），并接受[I-123]-MIBG、[F-18]-DA和2 [F-18]-氟-2-脱氧-D-葡萄糖（[F-18]-FDG）成像。断层扫描成像和正电子发射断层扫描（PET）图像进行了目视检查和quantitatives.Results所有5例患者的[I-123]-MIBG扫描，大大低估了疾病的程度相比，传统的CT和MRI。在[I-123]-MIBG扫描中观察到的所有病变均在[F-18]-DA扫描中检出，该扫描还检出了其他病变。尽管如此，[F-18]-DA也未能检测到CT和MRI上看到的许多病变。结论当[I-123]-MIBG或[F-18]-DA不能定位病灶时，[F-18]-FDG可作为诊断和定位转移性PHEO的辅助检查。这在侵袭性PHEC患者中尤为重要。
Background Although the majority of pheochromocytomas (PHEO) are benign, a subset is malignant. Computed tomography (CT) and magnetic resonance imaging (MRI) localize PHEO with high sensitivity but, because of limited specificity, [I-131]- or [I-123]-metaiodobenzylguanidine ([I-131]- or [I-123]-MIBG) is often used as a complementary agent. 6-[F-18]-fluorodopamine ([F-18]-DA) has been developed as a radiopharmaceutical for the targeting of noradrenergic pathways, and has been shown to result in a better detection rate of PHEO sites than MIBG; however, [F-18]-DA has shown a lack of accumulation in some patients with metastatic PHEO.Methods Five patients with widespread metastatic PHEO who had CT and MRI evidence of metastatic disease (one man and four women; age range, 25-64 years), and who underwent imaging with [I-123]-MIBG, [F-18]-DA and 2[F-18]-fluoro-2-deoxy-D-glucose ([F-18]-FDG), were evaluated retrospectively. Tomographic imaging was performed and positron emission tomography (PET) images were inspected visually and quantitatively.Results All five patients had [I-123]-MIBG scans that grossly underestimated the extent of disease when compared with conventional CT and MRI. All lesions seen on [I-123]-MIBG scans were detected on [F-18]-DA scans, which also detected additional lesions. Nonetheless, [F-18]-DA also failed to detect numerous lesions seen on CT and MRI. In all of these cases, [F-18]-FDG PET showed lesions that were not detected on either [I-123]-MIBG or [F-18]-DA scans.Conclusions When [I-123]-MIBG or [F-18]-DA fails to localize lesions seen on conventional imaging studies, [F-18]-FDG may be recommended as an ancillary test for the diagnosis and localization of metastatic PHEO. This is particularly important in patients with aggressive PHEC.